Psychodynamic Psychotherapy for Patients With Functional Somatic Disorders and the Road to Recovery

Abstract

Patients with functional somatic disorders (FSDs) are commonly encountered in clinical practice and are often considered difficult to treat. This article summarizes recent advances in the understanding of these disorders that have opened new avenues for treatment. Findings concerning the role of three related key biobehavioral systems (attachment, mentalizing, and impairments in epistemic trust) that seem to be centrally involved in FSDs, as viewed from a psychodynamic perspective, are discussed as well as empirical evidence supporting the efficacy of psychodynamic psychotherapy for patients with FSDs. Finally, the basic treatment principles of dynamic interpersonal therapy, an integrative psychodynamic treatment adapted for patients with FSDs, are outlined through a description of the treatment of a woman with chronic widespread pain and irritable bowel syndrome.

Keywords: functional somatic disorder; mentalizing; psychoanalytic; psychodynamic; somatic symptom disorder; trauma.